Duration of Antibiotics in Community Acquired Pneumonia, Physicians Fancy?

Abstract

In spite of guidelines on the use of antibiotics in Community acquired pneumonia (CAP), very often the antibiotics are prescribed for longer than necessary. Of the 37 in-patients with CAP over a 25-month period,12 had reasons for a longer antibiotic course. In the remaining 25, ten received antibiotics for ≤ 7 and 15 for more than 7 days. Respiratory rate (23.53± 4.32; p=0.039) and albumin levels (37.73±5.27; p=0.001) were higher in patients who received the longer course. Extent of opacities (p=0.690); single lobe 9 (60%). > 1 lobe unilateral 1 (100%) and bilateral 5 (55.6%) or the pattern; lobar 10(83.3%), segmental 1(20%) or interstitial 4 (50%); > 65 years 7 (53.8%); male 9 (60%), prior antibiotics 4 (57.1%), co-morbidities 11 (61.1%), Diabetes 8 (57.1%), aspiration risk 3 (42.9%) or higher CURB score 7(63.3%) did not influence the prescription. We find that physicians use their instinct rather than scientific backing in this decision. Often antibiotics are continued on discharge possibly due to a feeling of protection.